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There was no public announcement. A memo was sent to “stakeholders” (employees of the agency and hospitals providing psychiatric care) from Assistant Deputy Minister Patricia Li. “I am writing to advise you of a change being planned that will improve the lives of people living with mental illness,” she said. “Integrating the Psychiatric Patient Advocate Office’s rights advice and advocacy services with the Canadian Mental Health Association’s community-based mental health services will result in a more coordinated, patient-centred continuum of care.”

The reaction from mental health activists was swift and negative.

The Psychiatric Patient Advocate Office was their watchdog, their voice, their first line of defence against being involuntarily drugged, restrained and subjected to excessive force by the police.

But their concern went deeper than that. By embedding the Psychiatric Patience Advocate Office in the Canadian Mental Health Association — the main provider of outpatient services for people with mental disorders — the province was creating a serious conflict of interest. How could a patients’ advocate criticize the organization to which it belonged? How could it speak out when it was part of the health-care delivery system?

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The employees of the Psychiatric Patient Advocate Office are upset, too. They’ve been sending distress signals through their union.

Most Ontarians don’t know the Psychiatric Patient Advocate Office exists. But to people with mental disabilities and their families, it is as important as the Ontario Human Rights Commission or the provincial ombudsman.

It was created 28 years ago by former health minister Larry Grossman following a series of deaths at the Queen Street Mental Health Centre. The Star investigated and found prison-like conditions, involuntary drug treatment and unconsenting electroshock therapy in many of the province’s 10 psychiatric hospitals.

Grossman placed watchdogs in all 10 psychiatric hospitals and had them report to an arm’s-length government agency called the Psychiatric Patient Advocate Office.

Initially, the move was controversial. Hospital administrators regarded the patient advocates as spies and mental health activists weren’t sure whose side they were on.

But over time, the agency earned the respect of both sides. It won access to legal services for psychiatric patients, persuaded public authorities that police should not release information about an individual’s mental health without a risk assessment, ensured that individuals in psychiatric care received the social benefits to which they were entitled and spoke out on issues ranging from regulation of retirement homes to the stigma of mental illness.

Against all odds, the Psychiatric Patient Advocate Office survived 28 years of budget cuts, hospital closings and health-care reforms under six different governments.

It is ironic that it could now be felled — or downgraded into a branch of a charity — by a simple administrative procedure.

But it won’t happen without a fight. David Simpson, former director of the agency, has requested an urgent meeting with Health Minister Deb Matthews. Mental health advocates are organizing, blogging, reaching out and mobilizing. They have sent around an electronic petition and posted a position paper online.

It angers them that the province is doing this in midsummer when Queen’s Park is empty and Ontarians are not paying attention. It upsets them that there was no public consultation. And it worries them that the ministry is chipping away at the rights of one of the most vulnerable groups in society under the guise of “integrating” health services.

But their biggest concern is that the government is poised to walk away from its role as the guardian of Ontarians with mental disabilities.

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